13D1073329 CLIA NUMBER - PRAIRIE FAMILY

Laboratory Demographics

  • CLIA Code: 13D1073329
  • Facility Name: PRAIRIE FAMILY
  • Facility Address: 1130 W PRAIRIE AVE
    COEUR D'ALENE, ID
    ZIP 83815
  • Facility Phone: 208 209-0288
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: STEPHEN SMILEY
  • NPI Number: 1346444007
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 13D1073329
LAB Type Physician Office
Facility Name PRAIRIE FAMILY
Street 1130 W PRAIRIE AVE
City COEUR D'ALENE
State ID
ZIP 83815
Phone 208 209-0288
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director STEPHEN SMILEY

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This page was last updated on: 9/29/2025